Glatiramer acetate therapy for multiple sclerosis: A review

Jai Perumal, Massimo Filippi, Corey Ford, Kenneth Johnson, Robert Lisak, Luanne Metz, Alexandros Tselis, Mark Tullman, Omar Khan

Research output: Contribution to journalArticle

Abstract

The past decade has witnessed a revolution in the treatment of multiple sclerosis (MS), the most common demyelinating disorder of the human CNS. After being considered as an untreatable disease for more than a century, six disease-modifying treatments have been approved between 1993 and 2006. Glatiramer acetate (GA) is a worldwide drug approved for the treatment of relapsing-remitting MS in 1996. The drug is a synthetic copolymer of four amino acids based on the composition of myelin basic protein, one of several putative autoantigens implicated in the pathogenesis of MS. Three separate double-blind, placebo-controlled trials have established its efficacy in relapsing-remitting MS. Observations from an ongoing study, the longest prospective study in MS therapeutics so far, suggest that the effect of GA in reducing the relapse rate and neurological disability is maintained over a 10-year period. Independent investigators have identified several putative immunological mechanisms of action of GA, with the unique observation of the generation of GA-reactive T-helper 2 (anti-inflammatory) polarised lymphocytes within days to weeks of initiating therapy and sustaining an anti-inflammatory milieu for years in the peripheral immune system and, presumably, in the CNS. Emerging data from immunological and imaging studies quantifying axonal injury in the brain point towards neuroprotective abilities of GA. Combined with its remarkable safety and tolerability, long-term efficacy and neuroprotective effect, GA presents it self as a first-line choice in relapsing-remitting MS. and holds immense promise in developing its potential as a combination therapy in MS, as well as extending its indications to other neurodegenerative diseases.

Original languageEnglish
Pages (from-to)1019-1029
Number of pages11
JournalExpert Opinion on Drug Metabolism and Toxicology
Volume2
Issue number6
DOIs
Publication statusPublished - Dec 2006

Keywords

  • Glatiramer acetate
  • Immunomodulation therapy
  • Multiple sclerosis
  • Neuroprotection

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology

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  • Cite this

    Perumal, J., Filippi, M., Ford, C., Johnson, K., Lisak, R., Metz, L., Tselis, A., Tullman, M., & Khan, O. (2006). Glatiramer acetate therapy for multiple sclerosis: A review. Expert Opinion on Drug Metabolism and Toxicology, 2(6), 1019-1029. https://doi.org/10.1517/17425255.2.6.1019